Fact Sheets
The American Hospital Association (AHA) fact sheets on important issues facing hospitals and health systems. Fact Sheets define the terms of issues facing hospitals and health systems and provide in-depth explanations of the AHA's position on these issues.
The Issue
“Medicare for All” these days – a catch-all label that has become a part of the political dialogue – represents a variety of health coverage proposals that would do everything from establish a national health insurance program with no competition to create a public, Medicare-like option…
Some policymakers have expressed interest in “network matching” as a solution to surprise medical bills. To date, the only proposal defining such an approach, which was ultimately rejected, was included in the discussion draft of the Senate HELP Committee’s “Lower Health Care Costs Act.”
Section 603 of the Bipartisan Budget Act of 2015 requires that, with the exception of emergency
department (ED) services,1 services furnished in off-campus provider-based departments (PBDs) that began
billing under the outpatient prospective payment system (OPPS) on or after Nov. 2, 2015 (referred…
The Senate Health, Education, Labor and Pensions Committee June 19 introduced the Lower Health Care Costs Act (S.1895), legislation to prevent surprise medical bills, reduce prescription drug prices, improve transparency in health care, invest in public health and improve health information…
The House Energy and Commerce Committee in July passed legislation, The No Surprises Act (H.R. 2328), to prevent surprise medical bills.
AHA Ask: Policymakers should focus on assisting rural hospitals in their negotiations with payers and providing the incentives and resources needed to maintain…
Congress and CMS have set in motion an ambitious plan to significantly reform post-acute care, which includes long-term care hospitals (LTCH), inpatient rehabilitation facilities (IRF), skilled nursing facilities SNF) and home health (HH) agencies.
Inpatient rehabilitation facilities (IRFs) serve a unique and valuable role within the Medicare program by treating patients who require hospital-level care in conjunction with intensive rehabilitation.
The Balanced Budget Act of 1997 imposed caps on the number of residents for which each teaching hospital is eligible to receive Medicare direct graduate medical education (DGME) and indirect medical education (IME) payments. These caps have remained in place and have generally only been adjusted as…
Long-term care hospitals (LTCHs) serve a critical role within the Medicare program by treating the sickest patients who need extended hospital stays. This important role is under threat as the LTCH field implements the Bipartisan Budget Act of 2013 requirement for “site-neutral” payments for cases…
In 2019, the Centers for Medicare & Medicaid Services expanded Medicare coverage for virtual services and the agency provides waivers in some alternative payment models, but more fundamental change is needed to expand payment to all geographic areas and all services that are safe to provide via…